Obesity has become an epidemic in the United States that continues to increase at alarming rates every year. Obesity is a life threatening disease and can potentially compromise the life of a person. Bariatric surgery, also known as weight-loss surgery is currently the most common and primary treatment for severely obese patients, resulting in permanent weight-loss and improvement of serious medical conditions associated with obesity. This treatment, although very effective, causes nutritional complications and thus requires adequate nutrition and multivitamin supplementation.
Bariatric Surgery
Bariatric surgery has been found to be the most effective method to treat morbidly obese patients, and reduce the adverse effects of related medical problems, such as heart disease, diabetes, high blood pressure, and high cholesterol. Roux-en-Y gastric bypass (RYGBP) is the most common performed procedure for patients undergoing bariatric surgery because it offers greater weight loss and permanent results. Candidates for bariatric surgery must have a body mass index (BMI) of 40 or more or a BMI of 35 or more with an obesity-related condition, and have tried all other conventional weight loss methods. Weight loss is achieved through a significant reduction of the size of the stomach, thereby reducing food intake and absorption of nutrients. Patients who have this type of surgery lose an average of 60% to 70 % of excess body weight, but unfortunately they are at higher risk for nutritional deficiencies. It is therefore of extreme importance to ensure compliance to healthy dietary guidelines and adequate multivitamin supplementation.
Nutritional Complications of Bariatric Surgery
Nutritional deficiencies have been of great concern amongst surgeons, dietitians and patients because they are frequent after bariatric surgery. Nutritional complications may result as a consequence of the malabsorptive and restrictive nature of this surgical procedure. The most common nutritional deficiencies of bariatric surgery include protein, iron, vitamin B-12, calcium, folate, and fat-soluble vitamins (A, D, E, and K). Evidence shows that development of iron deficiency anemia is likely to occur in patients following bariatric surgery. Often, daily oral supplementation is sufficient to correct iron deficiency. Vitamin B-12 deficiency can also cause anemia, it is therefore highly recommended that a daily oral supplement be taken or that a monthly injection be given. Calcium deficiency can usually be prevented by taking a calcium supplement every day. Most nutritional deficiencies, however, can be managed through proper diet, pancreatic enzyme replacement, and the use of a multivitamin and mineral supplement. Additionally, postoperative care must include the intervention of a team of certified bariatric surgeons, physicians, and experienced dietitians to prevent and treat severe complications.
Nutrition Intervention and Education
Nutrition interventions to monitor and correct these deficiencies require compliance with a diet low in calories, appropriate protein level, and multivitamin supplementation to avoid severe complications. Permanent dietary changes consist of portion control, avoidance of fat, sodas and sweets, consumption of nutrient dense foods, eat more fruits and vegetables, eat slowly and chew foods thoroughly, refrain from drinking liquids when eating solid foods, maintain adequate protein intake as well as fluid, and last but not least small meals should be consumed throughout the day and vitamins should be taken between meals for optimal absorption.
Adequate Nutrition and Multivitamin Supplementation is key
The severity of obesity is greater than most people seem to realize, obesity can potentially compromise the life of a person if left untreated. Bariatric surgery can be life-saving, and consequently provide the patients with a better quality of life. Studies have found that the majority of obese patients who underwent bariatric surgery have experienced permanent weight loss. The medical problems associated with obesity have been either completely resolved or improved after bariatric surgery. However, patients may develop nutritional complications following surgery. The most commonly observed nutrient deficiencies are protein, iron, vitamin B-12, calcium, folate, and fat-soluble vitamins (A, D, E, and K). Adequate multivitamin and mineral supplementation can correct these deficiencies. In addition, postoperative support plays an essential role in the prevention and treatment of nutritional complications.
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